CIMC - Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland.
Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.
J Neuroimaging. 2022 Mar;32(2):273-278. doi: 10.1111/jon.12944. Epub 2021 Nov 1.
Susceptibility-weighted imaging (SWI) of nigrosome-1 is an emerging and clinically applicable imaging marker for parkinsonism, which can be derived from routinely performed brain MRI. The purpose of the study was to assess whether SWI can be used as a triage tool for more efficient selection of subsequent Dopamine Transporter Scan (DaTSCAN) single-photon emission computed tomography (SPECT).
We examined 72 consecutive patients with suspected parkinsonism with both DaTSCAN SPECT and SWI (48 in Philips Ingenia, 24 in GE Signa). Additionally, we examined 24 healthy controls with SWI (14 in Philips Ingenia, 10 in GE Signa). Diagnostic performance of SWI and DaTSCAN SPECT was assessed on the basis of clinical diagnosis, in terms of sensitivity, specificity, and diagnostic accuracy.
A total of 54 parkinsonism patients (69 years ± 9, 32 men), 18 nonparkinsonism patients (69.4 years ± 9, 10 men), and 24 healthy controls (62 years ± 8, 10 men) were recruited. SWI had a specificity of 92% and a sensitivity of 74%, whereas DaTSCAN SPECT had 83% and 94%, respectively. By preselecting patients with abnormal or inconclusive SWI, the diagnostic performance of DaTSCAN SPECT improved (specificity 100%, sensitivity 95%). Scans from Philips were associated with significantly lower image quality compared to GE (p < .001). The experienced rater outperformed the less experienced one in diagnostic accuracy (82% vs. 68%).
SWI can be used as triage tool because normal SWI can in most cases rule out parkinsonism. However, the performance of SWI depends on acquisition parameters and rater's experience.
黑质 1 区的磁敏感加权成像（SWI）是一种新兴的、可用于临床的帕金森病成像标志物，可以从常规进行的脑部 MRI 中获得。本研究旨在评估 SWI 是否可作为一种有效的筛选工具，以便更高效地选择随后的多巴胺转运蛋白扫描（DaTSCAN）单光子发射计算机断层扫描（SPECT）。
我们对 72 例疑似帕金森病患者同时进行了 DaTSCAN SPECT 和 SWI 检查（48 例在飞利浦 Ingenia 上进行，24 例在 GE Signa 上进行）。此外，我们还对 24 例健康对照者进行了 SWI 检查（14 例在飞利浦 Ingenia 上进行，10 例在 GE Signa 上进行）。根据临床诊断，我们评估了 SWI 和 DaTSCAN SPECT 的诊断性能，包括敏感性、特异性和诊断准确性。
共纳入 54 例帕金森病患者（69 岁±9，32 例男性）、18 例非帕金森病患者（69.4 岁±9，10 例男性）和 24 例健康对照者（62 岁±8，10 例男性）。SWI 的特异性为 92%，敏感性为 74%，而 DaTSCAN SPECT 的特异性和敏感性分别为 83%和 94%。通过对 SWI 异常或不确定的患者进行预筛选，DaTSCAN SPECT 的诊断性能得到了提高（特异性 100%，敏感性 95%）。与 GE 相比，飞利浦的扫描图像质量明显较低（p<.001）。经验丰富的阅片者在诊断准确性方面优于经验较少的阅片者（82% vs. 68%）。
SWI 可作为一种筛选工具，因为正常的 SWI 通常可以排除帕金森病。然而，SWI 的性能取决于采集参数和阅片者的经验。
